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中年和老年西班牙裔/拉丁裔成年人中自我报告的轻度认知障碍/痴呆症的医学诊断与神经认知功能的一致性:来自西班牙裔社区健康研究/拉丁裔研究(HCHS/SOL)和拉丁裔神经认知老化研究(SOL-INCA)的结果。

Concordance Between Self-Reported Medical Diagnosis of Mild Cognitive Impairment/Dementia and Neurocognitive Function Among Middle-Aged and Older Hispanic/Latino Adults: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and the Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA).

机构信息

Charles R. Drew University of Medicine and Science, Department of Urban Public Health, Los Angeles, CA, USA.

Wayne State University, Institute of Gerontology, Detroit, MI, USA.

出版信息

J Alzheimers Dis. 2022;88(1):45-55. doi: 10.3233/JAD-215060.

Abstract

BACKGROUND

Population-based studies typically rely on self-reported medical diagnosis (SRMD) of mild cognitive impairment (MCI)/dementia; however, links to objective neurocognitive function have not been established.

OBJECTIVE

Examine the association between SRMD of MCI/dementia and objective neurocognitive function among Hispanic/Latino adults.

METHODS

We conducted a case-control study using the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) baseline data and its ancillary SOL-Investigation of Neurocognitive Aging (SOL-INCA) at visit 2. Hispanic/Latino adults aged 50 years and older (n = 593) were administered neurocognitive tests: the Six-Item Screener (SIS), Brief-Spanish English Verbal Learning Test (B-SVELT Sum), B-SVELT Recall, Word Fluency Test (WF), Digit Symbol Substitution Test (DSS), and Trail Making Test A and B. Individual and global neurocognitive function scores were used for analyses. Propensity matching techniques and survey generalized linear regression models were used to compare SRMD of MCI/dementia with demographic, psychological, and cardiovascular risk matched controls. Complex survey design methods were applied.

RESULTS

There were 121 cases of SRMD of MCI/dementia and 472 propensity matched controls. At baseline, compared to matched controls, cases showed no differences in neurocognitive function (p > 0.05). At SOL-INCA visit 2, cases had poorer scores in global neurocognitive function (p < 0.05), B-SEVLT Sum, B-SEVLT Recall, WF, DSS, and Trail A (p < 0.01).

CONCLUSION

Observed differences in neurocognitive test scores between SRMD of MCI/dementia cases and matched controls were present at visit 2, but not at baseline in middle-aged and older Hispanic/Latino adults. These findings present initial evidence of the potential utility of SRMD of MCI/dementia in epidemiologic studies, where obtaining confirmation of diagnosis may not be feasible.

摘要

背景

基于人群的研究通常依赖于自我报告的轻度认知障碍 (MCI)/痴呆症的医学诊断 (SRMD);然而,与客观神经认知功能的联系尚未建立。

目的

研究西班牙裔/拉丁裔成年人中自我报告的 MCI/痴呆症与客观神经认知功能之间的关联。

方法

我们使用西班牙裔社区健康研究/拉丁裔研究 (HCHS/SOL) 基线数据及其辅助 SOL-神经认知老化研究 (SOL-INCA) 在访问 2 时进行了病例对照研究。年龄在 50 岁及以上的西班牙裔/拉丁裔成年人 (n=593) 接受了神经认知测试:六项目筛选器 (SIS)、简短西班牙语-英语词汇学习测试 (B-SVELT 总和)、B-SVELT 回忆、词汇流畅性测试 (WF)、数字符号替换测试 (DSS) 和 Trail Making Test A 和 B。个体和整体神经认知功能评分用于分析。采用倾向匹配技术和调查广义线性回归模型,将 MCI/dementia 的 SRMD 与人口统计学、心理学和心血管风险匹配的对照进行比较。应用复杂的调查设计方法。

结果

有 121 例 MCI/dementia 的 SRMD 病例和 472 例倾向匹配的对照。在基线时,与匹配的对照组相比,病例的神经认知功能无差异 (p>0.05)。在 SOL-INCA 访问 2 时,病例的整体神经认知功能评分较低 (p<0.05)、B-SEVLT 总和、B-SEVLT 回忆、WF、DSS 和 Trail A (p<0.01)。

结论

在中年和老年西班牙裔/拉丁裔成年人中,观察到 MCI/dementia 的 SRMD 病例与匹配对照之间的神经认知测试评分差异仅在访问 2 时存在,而在基线时不存在。这些发现初步证明了 MCI/dementia 的 SRMD 在流行病学研究中的潜在效用,在这些研究中,获得诊断的确认可能不可行。

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